this part of ideology that prevents us as we can slash our way to pros teary, that's not true. i want to say a word about the chamber of commerce, they lied, they did not fight for this program, they ran as against it in the newspaper, they tried and they foukt it all along, bh they saw the handwriting on the wall that the community and the supervisors and labor, we're going to have the same path, they turned on themselves and they tried to get [inaudible] from any business license in the city who would have meant that bank in america and wells fargo paid the same $25 fee or a self-employed plumber who had their own business. >> thank you, sir. >> next speaker. >> supervisors, [inaudible]

building and construction trades council, i think you find agreement with my colleagues in the trades, if they have any complaint with the health care security ordinance, that their demands on business don't go far enough, even our signature -- they pay for their worker's families, on those rare occasions when it provides health care, it provides it for long term workers in an industry that is fundamentally of one of temporary employment, and it doesn't provide for the worker's families. i think we would ask that as you work through the intersection in the health care security ordinance, you look not only the preserve but to expand them, i will point out that as i remarked before, the

single artist component of our unionized construction workforce is latino and for those workers, their extended families often include the undocumented, and the kind of coverage that health care of san sa*ns, the security ordinance provides, the health care does not provide, it is important to them and it will continue to be important to them for the foreseeable future. >> good afternoon, my name is brenda story, a lot of it has been said of our 13 thousand patients, over 6 thousand are uninsured and will remain uninsured for two reasons. one is many of them are undocumented and the second piece of that is that they will not be able to afford health care on their health care reform. it was encouraging to hear from legal council that there's a

way in which the current health care ordinance will be able to support our low-income families to be able to afford health care reform. lastly, i will say you already heard that we got some funds for our enrollment and we want to express to educate our community around all the options, people have to remain in health care and we will do our part to ensure that those 35 thousand uninsured individuals have a place where they can call their medical home, so thank you. >> thank you very much, ms. story. next speaker, please. >> good afternoon, supervisors, my name is shanell williams and i'm a student trustee at city college of san francisco representing 90 thousand students, so also some history, in 2004, i served on the youth commission, at that time we wrote legislation to expand the

healthy kids program to help to pave the way on what we have now in healthy san francisco, so the affordable health care act, we cannot allow it to undermine the health care security ordinance, as you know, many students, young folks, myself included utilize healthy san francisco and critically depend on this program to be able to stay healthy and work, it's critical for undocumented individuals, for part time workers which most students are part time workers and we often work multiple jobs to pay our expenses, my mother also relies on dialysis treatments and, you know, it's important to have access to health care for her as well. as you also heard earlier, more corporations are moving towards lowering hours and pushing folks into either becoming temporary or part time workers, we can't allow that to happen either, our community deserves fair wages and benefits and our communities deserve to be healthy and san francisco can continue to be a model for that.

i grew up here and i hold true that we can have a city that really supports all aof our community and i think we should provide health care for all and we do need both systems, i think we can do it, thank you. >> thank you very much, next speak e please. >> supervisors, thank you for myself and from seiu 1021 for holding this hearing, i retired from about 30 years of work from the health department about a year ago, last 8 years, i worked as a social worker in the emergency room, and i can tell you in the last three or furred years before i retired, before healthy san francisco was implemented, i could see a big change. there was a program in which we can send people who came to the emergency room, sleeked really for needs that weren't medical emergency, they needed a regular doctor, there's a program we would send people into and as years went on, we

saw that program being more and more effective. our union participated actively in intense negotiations before the passage of this health care security ordinance and we were concerned about a couple of thing, we were concerned about making sure employers required to pay, we want to make sure that that requirement continues, and we were concerned that there would be enough staffer or funding for providers, for people in the clinic, for people in the hospital unit that is are being taken care of in healthy san francisco patients, there's a connection between the two. if the business community, the companies are not paying into this program, then we have less money to provide -- to hire people to provide the care. so, we think it's important

for you to look at both issue, sufficient staffing and making sure that the employer requirement to pay continues. thank you for your time. >> thank you, thank you very much, next speaker. >> >> good afternoon, supervisors, thank you very much for having this important hearing, my name is pete, i'm with the california partnership and we're with the antipoverty organize sashes, i want to talk a little bit about context. i think i want to appeal to san francisco as a leader county in the state and i say we think that health and health care and healthy san francisco are antipoverty programs and that is in a context of 8.7 million californians being in poverty, we've got the infamous distinction of the highest people in poverty of any state in the country that we'd like to shake and we think san francisco can be a leader in

shaking that. i want to talk about how the affordable care abing and all of its office and is the idea that everybody deserves health care is being attacked at the state level and i can see it at the local level, we supported a bill at ab880 that would force wal-mart and large employers to take responsibility for underemployment their employees and not giving them health care, that stalled at the state level largely because businesses stepped in and said we don't want these organizations to be forced to provide health care. i think it's the same notion that's coming here that the deconstructing powerful programs that are antipoverty programs that builds on the state's health, the president chose to take a year and step back from the employer mandate, part of the affordable care act. we think that showing that san francisco has a choice right now to step up and say healthy san francisco is the way to go,

we're not going to give into the growing pressures of taking investment out of the community and say this is an antipoverty program, we want health care to resound and a right of all san franciscans and all californians, so we're asking for your leadership. >> thank you, sir, next speaker. >> good afternoon, supervisors, thank you so much for being here at this important hearing, my name is ali and i've been a registered nurse here for 36 years now, to consider weakening any part of healthy san francisco now when there is so much that's unknown about the affordable care act is concerning. the employer spending requirement needs to remain in place and that's really important. i have a story i would like to tell you, i'm sure we all have stories but this is a friend of my daughter, a 28 year-old full time restaurant worker would was born and raised in san

francisco, he was in a serious accident last year, on his way to work, he was on a scooter and a bicyclist ran a red light and he slammed into a post, so he was taken by ambulance to san francisco general, he suffered a severe concussion, had multiple abrasions, needed dozens stitches in his knee, his helmet saved him from more serious injury, he was unable to work to work for several weeks, he received a bill for over 32 thousand dollars for his care which is more than what he made in a year, luckily he was enrolled in healthy sa*ns from paid 250 dollars of this bill, which if he had to pay the full amount would have put him in dire straits, he will be mandated to buy insurance now, but with his income, he would be able to afford a high deductible plan

if he can afford any plan at all, we don't have medi cal yet, the aca is more about access to insurance, healthy san francisco is about access to health care, so let's leave it in tact. thank you. >> thank you, next speaker? >> hi, my name is claudia, i've been a san francisco resident for 30 years and i'm a registered nurse at kaiser for 8 year, i work in adult medicine with the latino community and i also work with maternity child health or labor and delivery, so i'm here today for personal and professional reasons. if i can leave you with one message today, it would be prevention. i personally am from a migrant family, we came here when i was four, so i know extensively how important health care is,

especially to families of migrant descent. from personal experience, i have two brothers who would have foregone care if it wasn't for healthy san francisco because their private insurance plans that are offered to them require expensive co-payments for themselves and for their families. my sister-in-law for example is a cardiac surgery survivor and i say survivor because she has my niece and nephew and in my homeland and her hard condition was never detected, because my brother was the primary head of household was able to have her on healthy san francisco and have the children on healthy san francisco kids, there was preventive diagnostic testing which found a murmur and found

a defect in her heart and had open heart surgery, if it wasn't detected, she would have died. on a professional level f, i work with the latino community, and they wait until they're completely sick because they can't afford the co-payments, they can't afford the medication, the doctors -- so, as i said, prevention, if we can prevent them going to the emergency room. >> thank you. >> thank you. >> next speaker, please. >> my name is brian sang, i'm a volunteer with the physicians organizing committee speaking on behalf of whatever members dr, trys and i, i have to back up with what the nurse had to say with the community and such care, my name is michael, i'm a pediatrician at the mission, most of my patient ares on medi cal with a sizable number of

family clients, the great number of my patient's parents are enrolled, [inaudible] perhaps in ants pace of the opening of the affordable care act, this is a disastrous idea, we'd be throwing people off an existing health care program in trade for vapor ware, real people will suffer because of this, it is a bad idea to shut that down until there is a replacement for it. we have other members of ours in psychiatry at sf general, one has work witched the jail psych unit, he practices in the community, he say that is many of his patients receive their meds through healthy sf, if we cut healthy sf, we're going to be throwing a lot more people off of their psych medications and this results in yet another

psych cut to a city that has been cutting care to psych for at least the past decade. >> thank you. 30 seconds, my apologies, it's been a long day. >> it's okay, supervisor. the last part of that is the bigger question is why health care costs so much. why should san franciscans and local businesses be set up against each other when huge health care monopolies need a hospital corporations, like kaiser claim non-profit status, do not pay taxes and drive up the cost of care while local government then makes cuts because of the reduced budgets. thank you. >> thank you, sir, next speaker. >> (speaking spanish).

>> good afternoon, supervisors, my name is maria, i'm a member of young workers united, we represent resident workers in san francisco, for the majority of our members, they're undocumented and healthy san francisco is a program that is vital for them and their families. (speaking through an interpreter). as a restaurant worker and someone who works in the store and prepares food, i have presently benefit framed the healthy san francisco program and the contributions of my

employers to my health care. in 2009, i suffered an emergency due to -- access to healthy san francisco meant life or death to me. the idea that such program will be taken away from workers is

terrible. our members and their health depend on this program. the health of workers who are undocumented who have very little resources and would work in restaurants should not be ignored. we need to conserve healthy san francisco. >> thank you, gracias. next speaker. >> good evening, thanks for having us, supervisor, my name is jane sanderval, as i currently work in an emergency department, i know first hand how a reduction in community resources leads to an increased dependence in emergency departments, often the emergency department is used as a primary means of health care, i see this on a daily basis.

the potential search in ed clientele due to a loss of nuances from the health care ordinance will tax an overloaded and overutilized and sometimes underfunded and understaffed department. i'm concerned ed wait times will increase, as they provide access to preventive services sufns immunizations and health screening, i'm concerned without these sss, clientele may not seek care until they have a crisis in their life. it is unclear to me how mandating an uninsured person to purchase health care [inaudible] those less fortunate are not limit today the marginalized and people who have become a casualty, these people will not be able to afford the co-payment and is

deductibles from the new insurance exchange. the loss of healthy san francisco would be a great disservice to the participants utilizing it, as the name imply, healthy san francisco promotes good health, all san franciscans have a right to affordable health care, let us maintain a healthy san francisco by not eliminating this program and by keeping the employee spending requirement by protecting the health care security ordinance. thank you. >> thank you very much, next speaker. >> good afternoon, supervisors, thank you for having this hearing, thank you for your stamina. so, my name is romagi and i was on the health commission for 12 years, it felt like 20, under mayor brown, during that time as connie ford referred to, we try today do two things, one, equal access to health care for every resident in san

francisco, two, universal access to affordability, and out of that came the health care services ordinance under the leadership of amiano, and by a vote of 11-0, signed by the mayor, it was passed in all of its lovely promises. this still stands today, under aca and the exchange as you have already said, we will expand access and that's a great thing, but today we hear that the attack is really about affordability and that's what we have to pay attention to, and some of our partners are coming to us from the business community and saying they want out. well, there is no everyday that there's a need for them to be

out. for affordability, we need them in, that should not change, i think the department of public health is not just a universal health council for the next four months when we're not going to get my mer evidence that we have today and the director of public health don't need to give you 45 more slides and 10 more meetings that we don't have evidence and we won't have more evidence for at least four to five months. >> let me ask you to finish your thought. >> thank you, so i would ask you as leaders for our city to please reconsider this universal health council. i've heard the train is out of the station and my community would say the horse is out of the barn, please do what supervisor cohen said, have our

tax paying health providers and service and non-profit groups go out there and expand, access instead of spending 150 thousand dollars or more to come and show you more slides on no new evidence. >> thank you very much. >> hi, i'm sar i with local 5299, we represent patient care and service workers at ucla medical center websinger ear here to support the health care security ordinance and healthy san francisco, while most of our members are fortunate enough to receive benefits, they have a class of secondhand workers who are hired at part time hours, they'll often work full time hours and they're not provided with health care, however, under the affordable care act, more employers will

have incentive tos do exactly what uc is doing and cut employees's hours so they don't have to provide health insurance, healthy san francisco has the incentive to cut hours as well as to provide health insurance to the many san francisco residents who will not quality under the affordable care act. all residents deserve health care. thank you. >> thank you very much. next speaker. >> good evening, thank you for your time. my name's kathy, i'm a part time teacher with the city college of san francisco and i'm a proud member of the activist committee with jobs with justice, as a teacher, i want to talk about our students, i'm aware that many of our students like my god children are lower income workers and i watch my god children, i watch other

students struggle if you make 14 to 15 dollars an hour, it's hard to make ends meet and i don't believe that covered california is likely to make health care affordable for them, i believe healthy san francisco is essential to the well being of our lee -- low-income students, make health care affordable and secure, making it secure for students who can't afford it or who won't be eligible under the aca act, my health care has never been so insecure. if i lose one class as a part timer, i'll lose my health care. i noted only lower my income, if i have to pay the affordable health care act, i may be forced into a situation where i have to choose between paying my own premiums or support my niece who doesn't have any health care at all.

i had the second job at asf to provide my father with better health care. it's really important, people should not have to struggle for health care, it's a human right. >> thank you very much, next speaker, please. >> hello supervisors, my name is tammy and i'm with the training program director at the women's community clinic where we serve 4 thousand uninsured women, we at the clinic celebrate the opportunity for 2 million california residents so have access to health care and insurance through the affordable care act legislation and we work tirelessly to enroll those who are qualified but we also see the health care security ordinance as an important complement, it provides a cohesive and multi-faceted health care institution that institutions the importance of quality preventive care, let me

highlight prevention, the significant financial cost and abuser on all residences, in a recent 2012 needs assessment that focused on the western addition fill mer, they use the er as care, i also want to reiterate to the supervisors, the lack of access to care impacts women, young women, poor communities and communities of color, so this ordinance is a women's health issue, they are the sole providers of their families and allows for their children to thrive, it creates a safety net and values health and wellness which impacts productivity and workplace excellence, it's an important safety net for young

people, those who service self-oriented jobs, or have aged out of their present tam coverage and it creates a pathway to continuing to create a healthy and thriving san francisco workforce, a necessity that assure that is we in san francisco continue to be leaders in innovation and excellence. thank you so much for your support. >> thank you. [inaudible].

>> i'm so excited about the affordable care act but so many san franciscans are going to be uninsured and wi need to care for them. i want to see us continue to be a model not only for the state of california, but also for the country and how we provide care to our constituents, thank you so much. >> thank you, next speaker. >> hi, i'm ellen shaffer, i'm with the equal health network, i'm speaking in advocacy for a better health care system, one of the questions i get is how can we live in this great rich country and have such a screwed up health care system and sometimes i try to explain it to people and sometimes i reach back to a couple of lines from my favorite musicals, he's trying to organize some garment workers as their first time out on strike and he says, you have to speak up, you have to fiekt,

and he says, things that a human heart would break at such a display at this, warmhearted men with money at stake can turn into heartless misbegun misers, i am so proud on days like this to live in a city where we know how to fiekt, we know what to fight for and i want to thank you supervisors which i know you will do which is to ko*n to fight for us and keep these programs. thanks. >> thank you, ms. shaffer, next speaker. >> supervisors, my name is paul and i'm here representing only myself, i'm an independent health care analyst and someone who is involve ined the development of both healthy san francisco and the health care security ordinance, i want to talk about the history, they are not the same thing, health care security ordinance of which tom i